06 Nov 2024 Pharmacist-led deprescribing of tramadol in long-term care
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In this TI Best Evidence webinar, Hafeez Dossa described his experience with a pharmacist-led intervention in a long-term care setting, which can dramatically reduce the inappropriate use of medications. Bottom line: while making changes that improve or don’t affect patient outcomes, deprescribing can also reduce drug costs, pharmacy dispensing, and nursing workload. Click the DOWNLOAD button to view or download a copy of the slide deck in PDF format.
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TITLE: Pharmacist-led deprescribing of tramadol in long-term care
WHEN: Wednesday, November 6th, 2024 at 12:00 PM PST [convert to your local time]
WHERE: This is a free webinar.
SPEAKER: Hafeez Dossa, Pharmacy Manager, Care Rx, Parksville, BC.
CME CREDITS: MainPro+/MOC Section 1 credits: 1.0. Those who registered, attended the webinar and completed the evaluation will receive their certificate.
About the topic: Hafeez Dossa, BSc is a pharmacist, managing a pharmacy that supports ~2,000 patients who live in long term care (LTC) and Assisted Living (AL) facilities across Vancouver Island. He is passionate about optimizing medication management, and spearheaded a deprescribing initiative in 2020 that resulted in safe deprescribing of PPIs in 50% of those taking them. Following that, he completed a 9-month quality improvement intervention for all LTC patients supported by his pharmacy who were taking tramadol. Using a combination of medication reviews, care conferences, and letters faxed to prescribers, recommendations were made for stopping or switching to alternative analgesic medications. Of 57 patients who were on tramadol and remained LTC residents 9 months later, 40 (70%) were no longer using tramadol: 12 completely discontinued and did not change to an alternative pain medication; 28 switched to an alternative analgesic. Just 17 (30%) remained on tramadol. The average monthly spend for each patient on tramadol prior to intervention was reduced by approximately $40 per month and total medication savings for all residents was estimated at $18,600 annually. Clear communication and collaborative care facilitated the reduction in inappropriate and unnecessary use of tramadol.
About the speaker: Hafeez Dossa is a Pharmacy Manager with Care Rx in Parksville, a pharmacy that services long term care and assisted living facilities across Vancouver Island. He completed his education first at SFU, where he received a B.Sc in Biomedical Physiology, then completed his B.Sc in Pharmacy at UBC. After traveling to Australia and New Zealand following the completion of his pharmacy degree (Skydiving over Abel Tasman National Park and Heli-Hiking the Franz Jozef Glacier were the highlights), he began his role with Care Rx. In this practice setting, Hafeez has found many opportunities to optimize medication management, as polypharmacy is essentially a given for patients upon admission (it’s rare to see a patient taking less than 8 medications when admitted). Using his passion for reducing the use of unnecessary medications, Hafeez has,through meaningful medication reviews and care conferences, achieved significant reductions in various drug classes including antipsychotics, antihypertensives, dementia medications, and most recently, proton pump inhibitors. In his spare time, Hafeez enjoys playing/watching hockey (is this the year for the Canucks?!), running, playing pickleball, and participating in triathlon events. Given his experience working in long term care, he has also found an interest in reading books that discuss life and what really matters near the end, and notes that there is lots we can learn about people who reflect on their lives to re-evaluate what the most important things really are. Two recommendations he has are Being Mortal, by Atul Gawande, and When Breath Becomes Air, by Paul Kalanithi.
LEARNING OBJECTIVES (by the end of this session, participants will be able to):
- establish patterns of use of potentially inappropriate medication and identify opportunities for deprescribing;
- communicate with other team members a recommendation to continue, adjust, or stop the medication;
- support changes and monitor for benefits, harms, and durability of these changes.
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